Provider Demographics
NPI:1891084125
Name:AL-DELFI, FIRAS (MBCHB,)
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:AL-DELFI
Suffix:
Gender:M
Credentials:MBCHB,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-4228
Mailing Address - Country:US
Mailing Address - Phone:318-675-5053
Mailing Address - Fax:318-675-4977
Practice Address - Street 1:1501 KINGS HWY
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-4228
Practice Address - Country:US
Practice Address - Phone:318-675-5053
Practice Address - Fax:318-675-4977
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301108783207ZP0102X
LAMD.207807207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology